When to Bill medical plan for dental treatment?

When to Bill medical plan for dental treatment?

What this means is that, increasingly, dental offices are being required to bill a patient’s medical plan for treatment that is essentially dental in nature. These types of treatment situations can include trauma from an accident, sleep apnea, oral or periodontal surgery procedures, or dental disease that is secondary to cancer treatment.

How many minutes can you bill for one code?

If you look up 40 minutes on the chart, you can bill for a maximum of 3 units (38 to 52 minutes). Each of the codes were performed for more than 15 minutes so each should be billed for 1 unit. You can then assign the extra unit to either 97110 or 97712 since they were treated for the same amount of time.

How long does it take to Bill PT services?

If a provider has a consistent practice of billing less than 15 minutes for a unit, this should be highlighted for review.

How does the 8 minute rule work in PT billing?

Untimed codes are reported as one unit per day. Timed codes are reported using the 8 Minute Rule. Untimed Codes are billed one unit per date of service regardless of the number of anatomical body areas treated. It does not matter if you spend 2 minutes or an hour treating the patient using these codes, you can only report one unit per code.

What this means is that, increasingly, dental offices are being required to bill a patient’s medical plan for treatment that is essentially dental in nature. These types of treatment situations can include trauma from an accident, sleep apnea, oral or periodontal surgery procedures, or dental disease that is secondary to cancer treatment.

If a provider has a consistent practice of billing less than 15 minutes for a unit, this should be highlighted for review.

If you look up 40 minutes on the chart, you can bill for a maximum of 3 units (38 to 52 minutes). Each of the codes were performed for more than 15 minutes so each should be billed for 1 unit. You can then assign the extra unit to either 97110 or 97712 since they were treated for the same amount of time.

How does the 8 minute rule work in billing?

If any 15 minute timed service is performed for 7 minutes or less on the same day as another 15 minute timed service that was also performed for 7 minutes or less and the total time of the two services is 8 minutes or greater, then you bill one unit for the service performed for the most minutes.